Pelvic floor dysfunction after childbirth: A systematic review of prevalence and associated risk factors

Background: Pelvic floor dysfunction (PFD) is a prevalent issue that significantly impacts women's health and overall quality of life, often resulting from factors such as childbirth, anatomical changes, and lifestyle choices. Despite its widespread occurrence, both awareness and effective treatment options remain insufficient. 

Objective: This study aims to systematically review existing literature regarding the prevalence, risk factors, outcomes, and conservative treatment options for PFD in women. 

Methods: A total of thirty-one peer-reviewed articles published between 2007 and 2025 were examined. The study designs encompassed randomized controlled trials, cohort studies, cross-sectional studies, and longitudinal studies, with participant numbers ranging from 40 to 3,000. 

Results: The findings indicated that vaginal delivery is consistently linked to a higher incidence of PFD compared to cesarean delivery. The risk of developing PFD was found to increase with perineal injury, elevated body mass index (BMI), advancing age, and imbalances in vaginal microflora. Weakness in pelvic floor muscles (PFM) was strongly associated with incontinence and dyspareunia. Conservative treatment methods, particularly pelvic floor muscle training (PFMT), biofeedback, and the use of pessaries, demonstrated effectiveness in alleviating symptoms, although caution was advised for early implementation. The psychological effects, including issues related to body image and diminished quality of life, were significant yet often overlooked. Awareness of PFD was notably low among various populations, underscoring the necessity for improved education and early screening initiatives. Imaging and biometric assessment tools were found to be effective for clinical evaluation. Additionally, cultural and regional variations highlighted the importance of personalized care approaches. 

Conclusion: PFD is a complex condition with enduring effects on women's health. Key contributing factors include the mode of delivery, trauma, and muscle function. Individualized conservative management strategies can enhance patient outcomes. Increased awareness, timely intervention, and culturally appropriate care are crucial for addressing this condition effectively.